510 NOTES, COMMENTS, AND ANSWERS TO CORRESPONDENTS.

Notes, Short Comments, and Answersto Correspondents.EDITORIAL NOTICE.

IT is most important that communications relating to theEditorial business of THE LANCET should be addressedexclusively " TO THE EDITORS," and not in any case to

any gentleman who may be supposed to be connected withthe Editorial staff. It is urgently necessary that attentionbe given to this notice.

-

1-t is especiallay requested that early intelligence of local eventshaving a medical interest, or which it is desirable to bringunder the notice of the profession, may be sent direct tothis Office.

Lectures, original articles, and reports should be written onone side only of the paper.

Letters, whether intended for insertion or for private informct-tion, must be authenticated by the names and addresses oftheir writers, not necessarily for publication.

We cannot prescribe or recommend practitioners.Local papers containing reports or news paragraphs should be

marked and addressed" To the Sub-Editor."Letters relating to the publication, sale, and advertising de-

partments of THE LANCET should be addressed ’ To theManager.

"

We cannot undertake to return MSS. not used.

MANAGER’S NOTICE."THE LANCET" AND ACCIDENT INSURANCE.

A LITHOGRAPHED CIRCULAR LETTER, emanating from anoffice in the Strand district, is being sent to members of themedical profession, offering to supply them with THE LANCET,in conjunction with an accident insurance policy. The Pro-

prietors of THE LANCET are in no way connected with thescheme (of which they cannot approve), and were not awareof its inception until their attention was called to it by areader who had received the circular.

THE LATE SIR WILLIAM SAVORY, BART., F.R.S., &c.

MESSRS. BAILLIÈRE, TifDAU., AND Cox have sent us a copy of a photo-- gravure by the Swan Electric Engraving Co., from a photograph byMessrs. Barraud, which they have published of the late Sir WilliamSavory. It is extremely well executed and an admirable portrait.The published price is half a guinea.

J. G., M.B., C.M.-Polyorchidism has frequently been diagnosed duringlife, but only one case (two testicles on one side) has been found onpost-mortem examination, and in this case there was no microscopicverification of the nature of the supposed additional testicle. Orth’s

Handbook of Pathological Anatomy contains an account of this case.Civis Coloniæ.-In answer to a question addressed to our readers lastweek two correspondents have recommended that communication- should be opened with "Cheiron," 460, Oxford-street, W.

PENSIONS TO POOR-LAW MEDICAL OFFICERS.

To the Editors of THE LANCET,

SIRS, — Kindly inform me through your correspondence columnsunder what Act of Parliament a board of guardians may grant a retiringpension to a district medical officer, what proportion it may bear to theformer salary, and whether a practitioner of fifty-live years of age and acontinuous service of twenty-nine years would be eligible for it.

I am, Sirs, yours faithfully,Aug. 7th, 1895. Ax OLD SERVANT.

*,* The Act of Parliament relating to superannuation is Vict 29, c. 31.The candidate for full superannuation-namely, two-thirds of his

-salary-must be sixty years of age and have spent forty years in thePoor-law service. Retirement after ten years’ service entitles thePoor-law medical officer to ten-sixtieths of his salary, with anaddition of one-sixtieth in respect to each additional year of service- until a maximum of forty-sixtieths (or two thirds) be reached.-ED. L.

MEDICAL TITLES.

To the Editors of THE LANCET.SIRS,—I am a mere licentiate of a College of Physicians and of a

College of Surgeons. My doorplate bears the modest inscriptionMr.——, Surgeon. By a recent legal decision it is doubtful whether alicentiate of a College of Physicians has the right to call himself aphysician. If this be true it is obvious that the same ruling must holdgood in the case of a licentiate of a College of Surgeons. Must I eraserihe word " surgeon " from my plate, and if so what am I to substitute ?

I am, Sirs, yours faithfully,Aug. 18th, 1895. A MERE LICENTIATE. L

THK UTILISATION OF THE LABOUR OF INMATES 01’’ WORKHOUSES.

A CORRESPONDENT makes the following suggestion to us :-" The utilisation of pauper labour without injury to the labour

market appears to be a difficult problem. But there are somechannels into which it could be turned with advantage to theworking community. For example, a free day-nursery for thechildren of women who have to work would be a great boon to thosepoor mothers. There are thousands of widows, deserted wives, andother women who are compelled to support themselves by workingout of their homes. They are often greatly handicapped by havingvery young children, for whose care some provision is, with

difficulty, made out of the small wages they earn so hardly. Thepoor-houses might not be the fittest possible place, but they arebetter than the streets. No doubt a free nursery would be a gainnot only to the mothers of the children but to the ratepayers. Itwo aid diminish sickness and accidents among the children, and itwould enable women, who now have to take their children into thehouse, to live outside on their own earnings. But, even if it cost alittle, money could not be better spent than in helping those whoare willing to do their utmost to keep off the rates."

As is the case with so many kindly and philanthropic proposalsthere is as much to be said against this one as for it. The

proper management of day-nurseries and crèches is an exceekl-

ingly difficult thing, and it is not very likely that many of theunfortunate derelict women our correspondent refers to would beable to bring to their task any of the qualities necessary for its

proper performance, and the risk of the spread of diseare woul beincreased. Again, a free day-nursery would have the objection of allentirely free things. The really hardworking and self-respectingwould be inclined to look down upon an institution as open to theiridle and dissolute sisters as to themselves, while the thoroughlyworthless would make of the charity almost a pelmanent home fortheir children. The States of New York and Massachusetts have donemore systematic work in this direction, we believe, than any of thecountries in Europe and, if our correspondent is interested in the

question he cannot do better than write to the New York Board ofCharities or the Bostoo Children’s Aid Society for information.

M. B., C.M.-Our correspondent asks our advice so that he may "knowhow to act should such things occur again." We hope they nevermay, for they disclose a lamentable state of affairs, but should they, ttwill be, in our opinion, his best, though his most disagreeable courseto disregard his fellow-practitioner entirely-to treat him as one whohas placed himself in a situation where the calls of etiquette cannot beworth listening to. His duty will be towards the patient, not hispatient strictly, but a sufferer.

A QUESTION OF SALARY FOII MEDICAL OFFICERS OF HEALTH,To the Editors of THE LANCET.

SIRs,-I am medical officer of health to a rural district council, and Ihave been requested to formulate a scale of fees for attendance andmedicine at the isolation hospital, which is a mile and a half from myresidence. The appointment most probably would be permanent, andthe administration would devolve on me. The number of patient"would vary. and at times there would not be any. What are the usualfees charged ; or what could be considered reasonable fees?

I am, Sirs, yours faithfully,Aug. 19th, 1895. INQUIRER.

*** No general rule can be laid down ; but a fixed salary should be

given for the general medical control and supervision of the estab-lishment, and the amount of this must necessarily depend upon thedistance of the hosrital from the writer’s residence, the nature ofthe resident hospital staff, the number of beds, and the frequency ofthe use of the hospital. To this should be added a fee for attendance

on each patient who is not, at his or her own cost, attended by anothermedical practitioner. The amount of this will, of course, dependupon the fees generally paid in the locality, and the fee should beless when multiple hospital patients are seen at one visit tbanwhtnjourneys have to be paid to see a single hospital patient. But thescale of fees should be fixed in advance, the medical attendant takingthe chance of the several attacks being lengthy and troublesome or ofshort duration and trivial.-ED. L.

Inquirer’s communication is receiving attention.

FBOZKN SECTIONS.To the Editors of THE LANCET.

SIRS,—Can any of your readers inform me where I could get any in-formation about frozen sections (say, of brain) ? Also what is the bestwork on brain localisation ? I am, Sirs, yours thankfully,July 20th, 1895. COLONIAL.

* Information as to the preparation of sections by freezing and othermethods will be found in Colman’s "Section Cutting and Staining,"Goodall’s " Microscopical Examination of the Human Brain," and.similar works. "Functions of the Brain," by Dr. Ferrier, and thechapter on Localisation in Dr. Gowers’ " Manual of Diseases of theNervous System " contain very complete information upon the subjectof brain localisation.-ED. L.

511NOTES, COMMENTS, AND ANSWERS TO CORRESPONDENTS.

"PROPER FACILITIES TO THE CORONER."

To the Editors of THE LANCET.

SIRS,—I beg to thank you for your prompt reply to my question inyour last issue; but from the opinion expressed in the following partof your sentence I must say that I very strongly dissent, as I thinkmost of my medical brethren will also. The coroner (non-medical, Imay state) for this district-and probably the same might be said ofmany others-seems to be decidedly averse to calling professionalwitnesses if he can by any means avoid doing so. Though inquests havebeen held on several cases in which, to my mind, the medical evidencewas a most important item, our coroner has always decided not tosummon the medical man. Now, without, of course, wishing to outstepthe province of the medical practitioner, I would simpl point out thatit is a gross injustice to any medical man that he should be requestedto politely " give a coroner previously to the inquest every proper in-formation within his power," and thus, of course, obviate the necessityof his being summoned. I grant that a great deal of explanation maypossibly rest in the interpretation of your word proper," your Mefini-tion of which term I should like to see. But I know that, for my ownpart, I should consider myself "very ill-advised" indeed to give gratisto any person, coroner or any other, professional information for whichI am honourably and legally entitled to receive one guinea. Per-

sonally, I am not at all anxious to appear in coroners’ courtsmore frequently than is absolutely necessary, but I do thinkthat it is most dishonouring and degrading to our professionthat its members should be thus quietly and privately induced to giveaway freely and gratuitously, as if it were worth nothing, that which isof legally recognised high value, is their own exclusive rightas membersof the profession, and should be duly prized accordingly. It seemsneedless for me to add that we have, of course, no claim for remunera-tion unless under summons, and all other information given is,apparently, never expected to be charged for.

I am, Sirs, yours faithfully,Aug. 19th, 1895. MEDICUS.B Our correspondent’s inference is by no means warranted. He

placed before us a general case, not a special one, and the

information that the coroner in a particular district is a lay-man and averse to calling professional witnesses has nothingto do with his previous communication. Our reply was

based on what we were asked, not on what we did not know.

"Proper" information means, of course, general information to be

given to a fellow citizen discharging a civic duty, not par-ticular scientific information which the medical man would

do well to withhold until upon his oath before the coroner.

Such courtesy as we have suggested as advisable between

a coroner and a medical man. whatever the profession or

proclivities of the coroner, so far from obviating the necessity ofsummoning the medical man, would in many doubtful cases leaddirectly to that course. We are perfectly alive to the high value ofmedical evidence at inquests, as the records of our columns from yearto year amply demonstrate. We must add that our correspondent issomewhat unjust as well as illogical in thus (thoughtlessls- no doubt)suggesting that we would recommend the adoption of any course ofaction "dishonouring and degrading to our profession."—ED. L.

Subscriber.-The most correct method is to print the name as followsMr. A- B-, M.B., C.M. This should defy criticism.

W. S. must pass at least the two final examinations required for the Paris M.D. degree.

M. V.-We cannot insert the letter. We do not recommend individual

practitioners."UNQUALIFIED PRACTICE."

To the Editors of THE LANCET,SIRS,-There is one aspect of the question to which I have seen

no reference yet in all the discussions. I require someone to do mydispensing, and to attend to anything while I am on my rounds, also tomake the "harmless, necessary" perfunctory calls which many of myold poor patients so much enjoy. Of course I refer to the visits betweenthe essential ones. For these purp03es, I have always found a younggentleman fresh from the hospital, and reading for his diploma, fullycompetent. In deference, however, to the growing feeling against un-qualified assistants, I am willing to pay the market price for a qualifiedman, though his time would hang rather heavily, as I prefer to do thevisiting myself. In response to my advertisement, only three qualifiedmen applied. One was in Ireland, two far off for a personal interview,and the others were considerably over forty years of age, and therefore,from my point of view, unsuitable. I am, Sirs, yours truly,Aug. 16th, 1895.

To the Editors of THE LANCET. PRINCIPAL.

To the Editors of THE LANCET.SIRS,—In THE LANCET of Aug. 17th appears a letter signed "Jus-

titia," complaining of the great evil which exists amongst us of unquali-fied practice. Beneath it you add a note expressing your opinion thatthe General Medical Council is always,ready to act in cases of coveringand unqualified practice. May I be allowed to respectfully differ fromyou in this particular? Some distance from me is a branch surgery far

away from the principal, carried on by a resident unqualified assistant,who signs death certificates right and left and otherwise acts as onlyone sine diploma" dares. Some two years ago I wrote to the GeneralMedica Council informing it of this flagrant misconduct, and gave

three cases, with names and addresses, of persons who had been attendedby the unqualified man and had died, the death certificates beingsigned by the principal, who in neither case had seen the patient,without the slightest trouble. The only satisfaction I got was a requestto procure statutory declarations-by which, I suppose affidavits weremeant-presumably at myowa expense, and, far worse, that of courtingpublicity in the matter. Naturally this course was not quite to mymind; so I let the matter rest, and have heard nothing since, and thesame kind of practice flourishes to-day. This is the "readiness to act"you so confidently put forward.—I am, Sirs, yours faithfully,Aug. 20th, 1895. NON SEQUITUR.

*** The General Medical Council possesses no machinery for collectingevidence, and does not exist for such purposes. Our correspondentwill find it ready to act when a case such as he details is broughtforward properly substantiated. No tribunal can do more; for theCouncil is a disciplinary court, not a detective body.-ED. L.

RAILWAY TitANSPORT FOR INVALIDS.

To the Editors of THE LANCET.

SIRS,-A reward was offered a short time ago in a London daily for"the best and simplest method by which an invalid can be transportedby rail so as to receive absolutely no jolting." The advertiser’s signature-was anonymous, and the offer emanated from a foreign address. Wouldany of your subscribers be kind enough to state anything they knowabout this offer or its result ? If a satisfactory and winning methodwas obtained by this means from some competitor in England for useabroad, some of us at home would like to know of it, as some satisfactoryand simple method has been for a long time much desired. I have beenunable to gather anything concerning the result of the offer by othermeans, so I trust that some of your subscribers may help me.

I am, Sirs, yours truly,Aug. 18th, 1895. RAILWAY..

METEOROLOGICAL READINGS.(Taken daily at 8.:30 a.m. by Steward’s Instruments.)

Tap LANCET Office, Aug. 22nd, 1895.

Medical Diary for the ensuing Week.OPERATIONS.

METROPOLITAN HOSPITALS.MONDAY.-London (2 P.M.),St. Bartholomew’s (1.30 PM.), St. Thomas’s.

(3.30 P.M.), St. George’s (1 P.M.),St. Mark’s (2 P.M.), Chelsea (2 P.M.),Samaritan (Gynaecological, by Physicians, 2 P.M.), Soho-square(2 P.M.), Koyai Orthopædic (2 P.M.), City Orthopedic (4 P.M.), Gt.Northern Central (Gynaecological, 2.30 p.M ).

TUESDAY.-London (2 P.M.), St. Bartholomew’s (1.30 P.M). Guy’s(1.30 P.M.), St. Thomas’s (330 P.M), Westminster (2 P.M.). WestLondon (2 30 PM.), University College (2 P M ), St. George’s (1 P.M.),St. Marv’s (1.30 P.M.), St. Mark’s (2 30 P.M Cancer (2 P.M ).

WEDNESDAY.-St.Bartbolomew’s (1.30P.M ),University Collegp (2 P.M.),Royal Free (2 p M.). Middlesex (1.30 P.M.), Charing-cross (3 P.M.), St.Thomas’s (2 P.M.), London (2 P.M.). King’s College (2 p M.), NationalOrthopaedie (10 A.M.), St. Peter’s (2 P.M.), Samaritan (2.30 P.M.), Gt.Ormond-street (9.30 A.M.), Gt. Northern Central (2.30 P.M ).

THURSDAY.-St. Bartholomew’s (1.30 P.M.), St. Thomas’s (3.30 P.M.),Umversity College (2 P.M.), Charing-cross (3 P.M.). St. George’s (1 P.M.), London (2 P.M.). King’s College (2 P.M.), Middlesex (2 P.M.),Soho-square (2 P.M.), North-West London (2 P.M.).

FRIDAY.-London (2 P.M ), St. Bartholomew’s (130 P.M.), St. Thomas’s(3.30 P.M.), Guy’s (1.30 P M.), Charing-cross (3 P.M.). St. George’s(1 P.M.), King’s College (2 P.M.), Cancer (2 P.M.), Chelsea (2 P.M.),Gt. Northern Central (2.30 p ar.).

SATURDAY.-Royal Free (9 A.M. and 2 p M.), Middlesex (1.30 P.M.),St. Thomas’s (2 P.M.), London (2 P.M.), University College (9.15 A.M.),Charing cross (3 p M.), St. George’s (1 P.M.), Cancer (2 p.M ).

At the Royal Eye Hospital (2 P.M.), the Royal London Ophthalmic(10 A.M.), the Royal Westminster Ophthalmic (1.30 P.M.), and theCentral London Ophthalmic Hospitals operations are performed daily.

During the week marked copies of the following newspapershave been received:-Toronto Mail, Birmingham Argus, NorthWilts Herald, Birmingham Post, Ilfracombe Gazette, Eastern Morn-ing News, Kilburn Post, Manchester Guardian, Dublin EveningHp,rald, Carliste Express, Cambrian, Irish Times, Naval and MatitaryRecord, Newcastle Leader, Darlington Times, Putney News, BrightonGazette, Salisbury Journal, Cheltenham Examiner. Midland DailyTelegraph, J eith Burghs, Pilot, Montrose Review, Brecknock Beacon,Le Courrier de la Presse, Tottenham and Edmonton Weekly Ilerald,Derby Daily Telegraph, Lincolnshire Chronicle, Torquay Directory,Cape Argus, Coventry Times, Inverness Ccvrier, St. Bartltolomew’sHospital Journal, Court Journal, Tunbridge Wells Advertiser, FalkirkHerald, Goole TimeR, Keighley Herald, Ayrshire Post, StaffordshireChroniele, Morning Leader, &c., &c.,